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Jackson v. Astrue

January 5, 2009


The opinion of the court was delivered by: Gary S. Austin United States Magistrate Judge



Plaintiff Stephen R. Jackson ("Plaintiff") seeks judicial review of a final decision of the Commissioner of Social Security ("Commissioner") denying his application for disability insurance benefits pursuant to Title II of the Social Security Act. The matter is currently before the Court on the parties' briefs, which were submitted, without oral argument, to the Honorable Dennis L. Beck, United States Magistrate Judge.*fn1


Plaintiff filed his initial application in January 2005, alleging disability since July 11, 2002, due to nerve damage in his left arm, "CRSD," heart problems and depression. AR 50-52, 63-72. His application was denied initially and on appeal, and Plaintiff requested a hearing before an Administrative Law Judge ("ALJ"). AR 16, 37-41, 42-46. ALJ Howard Treblin held a hearing on January 23, 2007, and issued an order denying benefits on July 6, 2007. AR 21-32, 935-961. On December 26, 2007, the Appeals Council denied review. AR 5-7.

Hearing Testimony

ALJ Treblin held a hearing on January 23, 2007, in Stockton, California. Plaintiff appeared and testified with his attorney, Jorge Mastache. AR 935.

Plaintiff testified that he was 47 years old, 5'11" and weighed about 260 pounds. AR 938-939. His normal weight was around 280 and he was not trying to lose weight. AR 937. Plaintiff was married and had a driver's license, although he only drives if he has to. AR 939-940. Plaintiff completed the eleventh grade. He last worked in July 2002 in pest control, but also worked as a security guard at a casino. AR 940-941.

He lives with his wife and two children, ages 9 and 7, in an apartment. AR 954. Plaintiff explained that he stopped working because he was injured on the job when he hit an air conditioning unit with his left arm. AR 942. Currently, he has a disease called "RSDS" in his left arm and has constant pain in that arm. AR 942. The pain now travels to his legs and chest. AR 943. He denied having any mental problems apart from "everyday life." AR 944. Plaintiff has an implanted spine stimulator that operates all the time. AR 944. If he has severe pain, he can adjust the level of electrical stimulation. AR 946. He was using a duragesic patch for pain but has pain all the time. AR 946. The pain in his left arm goes away, but not the pain in his other limbs. AR 947. On a bad day, he rates his pain as a 10 out of 10 and believed that he had more bad days than good days. On a good day, he was lucky to stay at an 8. AR 947. Plaintiff estimated that during the day, he's on his feet for maybe a couple of hours. AR 948. He was off his feet at least 10 hours during the day, although he tries to walk around and do what he can. AR 949.

Plaintiff thought he could lift or carry five pounds, but could not lift anything over his head. He could sit for one hour before needing to get up. AR 950. He could stand for 10 to 15 minutes but could only walk a short distance. He used a cane, walker and wheelchair previously, but now makes himself walk. AR 951. He has problems holding on to things with his right hand, but not as much with his left. AR 952. Plaintiff has problems with his memory, concentration and focus, as well as problems getting along with people. AR 953. He believed that the pain patch caused some of these problems. AR 954. It also takes him a lot longer to do things. AR 956.

During the day, he usually just sits on the couch. He tries to help with the laundry, dishes, light cleaning and dusting, and do whatever he can to help around the house. AR 957.

When questioned by his attorney, Plaintiff explained that right now, the stimulator is only stimulating his left arm. His doctor also plans to use stimulators on his right arm and both legs. AR 958. When the stimulator goes off in response to pain, he is pain free for hours. His legs and his right arm, though, continue to cause pain. AR 959. His arms and legs are also becoming cold. AR 959. His right arm cramps up and he can't use it, and this happens two or three times a day, for a few minutes. AR 960.

Medical Record

Plaintiff suffered a work-related injury on July 9, 2002, when he slipped and hit the edge of his upper left arm against an air conditioning unit. AR 134. He suffered a significant contusion to at least the left radial nerve. AR 158. An EMG of his left upper extremity performed in August 2002 showed evidence of a mild median neuropathy. AR 133.

On January 20, 2003, Todd Smith. M.D., performed a surgical exploration of Plaintiff's left radial nerve. Prior to the surgery, he was assessed with a radial nerve contusion with neuropraxia in his left upper extremity and mild asymptomatic left carpal tunnel syndrome ("CTS"). AR 267-270.

Plaintiff returned to Dr. Smith on April 30, 2003, and reported that he continued to have a burning and lancinating type pain in his entire left upper extremity. AR 282. On examination, the swelling had decreased but he had pain over the entire aspect of the nerve. He also had mildly decreased sensation along the dorsoradial aspect of his left thumb and index finger. AR 282. Dr. Smith diagnosed left upper extremity radial nerve neuropraxia with neuropathic pain syndrome and recommended that Plaintiff be referred for pain management. AR 282.

On May 29, 2003, Plaintiff saw Bruce Gesson, M.D. for reflex sympathetic distrophy ("RSD") of his left arm. On examination, his left hand and arm were swollen with some cyanosis. He was "exquisitely sensitive" to touch in his right upper arm. His reflexes were somewhat depressed and he had decreased strength in his hands. Dr. Gesson believed that Plaintiff suffered from complex regional pain syndrome ("CRPS"), otherwise known as RSD. AR 261-262.

On June 27, 2003, Plaintiff underwent an epidural sympathetic nerve block. AR 276-277. Plaintiff saw Elliot S. Krames, M.D., on September 23, 2003, for evaluation and treatment of his left arm pain. On examination, he had hypesthesia to pinprick sensation to the left arm, range of motion of the left arm joint was within normal limits, his left arm was mildly cooler than the right arm, and there was no apparent swelling. He had decreased strength in the left upper extremity. Based on his examination and review of records, Dr. Krames diagnosed Plaintiff with left upper extremity CRPS with central neuropathic pain syndrome. Plaintiff was a good candidate for a spinal cord stimulator. He also recommended that Plaintiff see a psychologist for an initial evaluation and cognitive behavior therapy. AR 384-387.

On November 20, 2003, Plaintiff saw Kirsten Meadows, M.A., for a psychological evaluation. He rated his pain at a 10 on average and a 9 at its lowest. He also reported mood swings, irritability and difficulty with memory and concentration secondary to pain. Plaintiff reported that he spends his time taking care of his two children and helping out around the house. He also reported that he was very involved in his church. On mental status examination, his judgment was adequate and there were no signs of confusion. Testing indicated that he may be "trying to emphasize how difficult his life is while claiming to be unusually psychologically resilient." He had "troublesome attitudes towards pain" and could perceive his pain as intractable. Testing further revealed that Plaintiff was socially adaptable and could relate well in a variety of social settings, although he may be guarded about reporting social conflicts. Ms. Meadows diagnosed ...

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